The Short-Term Results of ABO Incompatible Kidney Transplantation: Comparison with ABO Compatible Grafts

Abstract

Introduction: ABO incompatible (ABOi) kidney transplantation (KT) is increasingly preformed. But detailed comparative data with ABO compatible (ABOc) KT about preoperative risk factors, patients survival, graft survival, graft function, and complications are still scare. The present study was aimed at these issues. Methods: In this retrospective study, we compared 35 consecutive ABOi KT to 138 ABOc KT used same immunosuppressive regimens with respect to preoperative demographic factors, immunologic risk factor, postoperative renal function (serum creatinine, estimating glomerular filtration rate, and urine protein-to-creatinine ratio), patients and graft survival, acute rejection, surgical complication, medical complication, infectious complication, duration of hospital stay and re-admission rate until 2 years after KT. Results: Baseline characteristics were similar among two groups except donor age (p=0.008, 37.5 ± 8.7 in ABOi group vs 42.4 ± 11.5 in ABOc group) and positivity (PRA>20%) of panel reactive antigen (P= 0.004, 45.7% in ABOi group vs 21.7% in ABOc group). There were no significant differences of patients and graft survival, postoperative renal function, total surgical & infectious complications. But, in detail, incidence of bleeding complication and BK viral infection was high in ABOi group (P=0.002 and 0.005, respectively). Also, medical complications (P=0.005), pre-operative hospital day (p< 0.001), re-admission rate and acute rejection episode (P=0.007) were common in ABOi group. Conclusions: We concluded that ABOi KT is a viable and safe option for patients whose only donor is ABO incompatible.